“Living an unfilled life carries a greater risk of harm than what may befall someone in pursuit of their dreams. The latter can be folded into a story; the former is the absence of story. The latter is a movement towards possibility; the former is the disintegration of it.”

Gord Tulloch and Sarah Schulman [1]

While we may talk too much about beds in relation to social care, I don’t think we talk anything like enough about dreams.

That doesn’t mean we don’t think ahead. The social care world is all about plans. But in this world people have ‘goals’ to meet and ‘outcomes’ to achieve.

Specific. Measurable. Achievable. Realistic. Time limited.

SMART.

Now think about your own dreams and desires. Do they meet the SMART criteria?

This is how serviceland translates dreams into ‘unrealistic expectations’.

I remember a conversation with a social worker many years ago, where she told me about someone she was supporting who wanted to be a singer on a cruise ship. I don’t remember her exact words, but she basically implied two things. First, that was impossible. And second, it wasn’t really anything to do with her role anyway.

That’s not my job.

But surely that was exactly her job? To be curious. To explore the person’s dream with her. To understand what appealed. Was it about the travel? The singing? The ship? All of those, or something else? Was talking about her dream – speaking the words – enough? It might have been. Or did this conversation offer a glimpse of a North Star? Glimmers of possibility. Options to explore?

“We plot our dreams and then work backwards, working out what practical steps will take us from our current reality towards this dream. We think about whom we know: who is the first person that can help us along this path. Are they in the room, or do we need to find them.”

Hilary Cottam [2]

I bet there are times when you’ve discussed your dreams with your family or friends. When you’ve relished the opportunity to expose your imagination and describe your fantasies. I’m sure you remember how vulnerable you felt in that moment. That you know how validating it is to have someone else indulge in your desires with you. How delicious that shared speculation is. And how painful it is if the person you’ve trusted with your dreams responds by saying “oh but of course that can never happen”.

What right do we have to crush somebody else’s dreams?

It’s almost as if we don’t expect older people and disabled people to have aspirations. Articles in the press both reflect and fuel pervasive attitudes, with headlines like the ones below implying the pursuit of dreams is only possible if people ‘defy’ their age and ‘overcome’ their disability – a grim illustration of everyday ageism and ableism.

• “Despite her age, she never gave up on her dreams”
• “101-year-old artist defies age to pursue artistic passions”
• “7 unsung heroes who battled disability to achieve their dreams”
• “10 famous individuals who overcame disability to follow their dreams”
• “Courageous young girl pursues her dreams despite disability”
• “An extraordinary man who dreams despite disability”

Jan Sutton writes that “the idea that disability is synonymous with inability has become totally embedded in our society”.

“Disabled people have had to learn to ‘sell’ our inabilities, our ‘can’t do’s’, in order to get the basic level of support that we need to survive… And, frankly, it’s just too risky not to…Like so many others in my position, now that I have secured the level of support that I need, I don’t want to do anything that will threaten this. And so I have learnt to only talk about what I can’t do; I have learnt not to mention my skills, my experience and my abilities. I have learnt not to mention my dreams, my ambitions and my intentions. More than that, I try to make sure that those who assess me have no idea that these dreams aspiration and intentions even exist.”

Jan Sutton [3]

Do we really think some people don’t ‘deserve’ ambitions?

Or – like love – are dreams just something we avoid talking about because they don’t come in ‘care packages’?

“What if they ask for something I can’t deliver?” [4]

In this Social Care Future video, people share the things they would love to do with their lives if the right support was available.

These aspirations fall into two categories. They relate either to people’s fundamental human rights (“be classed as an equal”, “hold down a job”, “get married to my partner”, “doing what I want to do”) or to bigger ambitions (“go motor racing”, “go travelling around the world”, “playing for Man United”.)

Or to split them another way, they either relate to love (friends and relationships) or purpose.

Now think about our standard set of service solutions.

Do any of them offer any of those?

I heard a lovely story recently about a couple who’d been referred to a social work team. The wife was living with dementia, and her husband needed a break. The social worker who shared the story admitted that her first thoughts – before meeting the couple – had involved ‘respite’ and ‘day centres’. But when she met them, and learned more about them, she discovered they loved painting – and each other – and she was able to find a local art class for them both to join. They didn’t want time apart – or a service – just a chance to do something different. Something that brought them both joy.

How frequently we imagine that fulfilling dreams will cost the earth (another reason to avoid discussing them?) But what about the cost of not fulfilling dreams?

And what about the damage of limiting people’s lives to the extent that what most of us might consider ordinary feels like something extraordinary?

 “A few years ago, I ran a workshop at a conference in Chester where we asked, “What do you dream of doing? And what needs to happen to make that happen?” What was upsetting and so frustrating was that 75% of the people said things like “go to the pub to see my mates”, “go out bowling”, “watch a movie with my mates.” None of these things should be dreams; they could happen this evening if not next week! Why are we settling for so little when it comes to supporting people with learning disabilities? It’s not down to funding; it’s down to us forgetting to approach our work with joy and share that with the people we support, becoming part of their dreams and making them happen.”

Paul Richards [5]

So, this is my plea for us to centre our conversations on what matters most to people, not to services.

And instead of writing off dreams as ‘unrealistic expectations’ or restricting them to ‘measurable outcomes’ (i.e. “having everything you do logged and judged” [6]) to adopt one of Tricia Nicoll’s favourite questions instead:

“What would it take?”

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References

[1] The trampoline effect: redesigning our social safety nets, Gord Tulloch and Sarah Schulman, Reach Press, 2020

[2] Radical help: How we can remake the relationships between us and revolutionise the welfare state, Hilary Cottam, Virago Press Ltd, 2018

[3] Striving: a right, a responsibility and a risk, Jan Sutton, Authors of our lives, 19 February 2014

[4] How to be human, Bryony Shannon, Rewriting social care, 10 February 2024

[5] Hello New York! Paul Richards, Medium, 8 May 2024

[6] Parley Vouz Health & Social Care? (An A to Z of Carespeak), Mark Neary, Love, Belief and Balls